Abstract
OBJECTIVE
1) Understand the impact of racial/ethnic disparities on access to care for children with frequent ear infections. 2) Identify disparities to target for future interventions.
METHOD
The National Health Interview Survey (1997 to 2006) was utilized to identify children suffering from frequent ear infections (FEI), defined as 3 or more ear infections in the preceding year. Age, sex, race/ethnicity, income level and insurance status were extracted. Access to care was measured by ability to afford medical care and prescription medications, specialist visitation, and emergency room visits. Multivariate analyses determined the influence of demographic variables on the ability to access health care resources.
RESULTS
An annualized population of 4.65 plus/minus 0.08 million children reported FEI. Overall, 3.7% could not afford care, 5.6% could not afford prescriptions, and only 25.8% saw a specialist. A larger percent of the Black (42.7%) and Hispanic children (34.5%) with FEI were below the poverty level versus White children (12.4%, p<0.001). 18.2% of Hispanic children were uninsured versus 6.5% of White children (p<0.001). On multivariate analysis, children with FEI that were Black or Hispanic had increased odds ratios relative to White children for (1) not being able to afford prescription medications (odds ratios, 1.76 and 1.47, respectively, p<0.002), (2) not being able to see a specialist (OR, 1.62 and 1.86, p<0.001) and (3) visiting the emergency room (OR, 2.50 and 1.32, p<0.001).
CONCLUSION
Racial/ethnic disparities among children with FEI significantly influence healthcare resource access and utilization. These disparities should be targeted for intervention.